Healthcare Provider Details

I. General information

NPI: 1215970223
Provider Name (Legal Business Name): GEISINGER JERSEY SHORE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 THOMPSON ST
JERSEY SHORE PA
17740-1729
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-398-0100
  • Fax: 570-398-4412
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number101401
License Number StatePA

VIII. Authorized Official

Name: CINDY L MULL
Title or Position: SYSTEM DIRECTOR ENROLLMENTS
Credential:
Phone: 570-271-6603